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Erkan et al. Mini-invasive Surg 2018;2:30 Mini-invasive Surgery
DOI: 10.20517/2574-1225.2018.51

Review Open Access

Current state of transanal minimally invasive
surgery in the management of rectal cancer

Arman Erkan, Justin J. Kelly, John R. T. Monson

Center for Colon & Rectal Surgery, AdventHealth, Orlando, FL 32804, USA.

Correspondence to: Dr. John R.T. Monson, Center for Colon & Rectal Surgery, AdventHealth, Orlando, FL 32804, USA.
E-mail: john.monson.md@flhosp.org

How to cite this article: Erkan A, Kelly JJ, Monson JRT. Current state of transanal minimally invasive surgery in the management
of rectal cancer. Mini-invasive Surg 2018;2:30. http://dx.doi.org/10.20517/2574-1225.2018.51
Received: 11 Jul 2018 First Decision: 23 Aug 2018 Revised: 3 Sep 2018 Accepted: 4 Sep 2018 Published: 26 Sep 2018

Science Editor: Gordon N. Buchanan Copy Editor: Cui Yu Production Editor: Huan-Liang Wu

Abstract
Rectal cancer surgery has undergone a rapid change over the last few decades. We have come a long way from
abdominoperineal resection to minimally invasive sphincter preserving techniques. Colorectal cancer screening
programs made it possible to diagnose patients at earlier stages and this has led to question the necessity of radical
surgery and the possibility of organ preservation. The platform most recently added to the surgical armamentarium is
transanal minimally invasive surgery (TAMIS). It utilizes conventional laparoscopic tools to perform endoluminal surgery
in rectum. Along with the conceptual changes in rectal cancer management, TAMIS is more frequently used for local
excision of malignant rectal tumors. This review highlights the recent advances and current state of the role of TAMIS in
the management of rectal cancer at various stages.

Keywords: Rectal cancer, transanal minimally invasive surgery, local excision

INTRODUCTION
The ultimate aim of rectal cancer treatment is to provide safe oncological cure while maintaining enteral
continuity and preserving sphincter function. In many cases, it is challenging to achieve excellent results
[1]
in all three components .

The multimodal treatment of rectal cancer is following a similar path to breast cancer: less invasive surgi-
cal techniques are being utilized to preserve anatomical and functional integrity without compromising
oncological outcomes. It has undergone a seismic change from abdominoperineal resection to low anterior
resection, local excision and finally watch-and-wait approach, following neoadjuvant treatment in select

© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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